Vagifem is a tablet-style medication that can be inserted directly into the vagina using a convenient applicator made of plastic. The medication works to treat the symptoms that occur in the female body during the menopause. More information

A doctor will review your order and write you a prescription, if appropriate. This prescription is then forwarded to a pharmacy. The pharmacy will have your medicine delivered to you within one to three working days. Read more about this process here.

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Vagifem or Estradiol is a medication used for female hormone replacement therapy. This drug can help women in the menopause reduce their symptoms, including itching, burning and vaginal dryness. Because many women during menopause experience symptoms as a result of limited oestrogen, Vagifem creates additional synthetic oestrogen. Typically, Vagifem is a medication which will be applied directly inside of the vagina using a special single-use applicator. Products taken by mouth have greater risks of side effects as the body may absorb more oestrogen this way.  

What is Vagifem? 

Vagifem is a tablet-style medication that can be inserted directly into the vagina using a convenient applicator made of plastic. The medication works to treat the symptoms that occur in the female body during the menopause. Specifically, this drug is particularly effective at treating symptoms caused by vaginal dryness or atrophy. Vagifem contains a synthetic hormone named oestradiol, which belongs to the same group of hormones in the body as oestrogen. The substance treats the problems caused by dropping levels of oestrogen in the body. Because Vagifem is inserted directly into the vagina it can provide more immediate relief than orally-administered tablets for discomfort in that area.  

When is Vagifem used? 

Vagifem is used only for women experiencing menopausal symptoms around and inside of the vagina. Studies have shown that Vagifem is effective at reducing various problematic symptoms for women, including soreness, irritation, pain during intercourse, vaginal dryness, itching, and painful urination.  Many people prefer to take hormonal treatments like Vagifem in tablet form for several reasons. When the Vagifem substance is inserted directly into the vagina, it provides a safe and quick form of treatment. Additionally, the fact that the treatment is localised means that the risk of full-body side effects is minimised. This is beneficial compared to other forms of hormone replacement therapy.  

How do you use Vagifem? 

When taking a new form of hormone replacement therapy, or HRT like Vagifem, it is essential to follow the instructions provided by your doctor, or on the patient leaflet given by your pharmacist. Whenever you get a refill, make sure that you check the instructions again to ensure that you don't need to do anything differently. If you have any questions on how to use Vagifem, you can speak to a doctor or pharmacist about them. Usually, Vagifem will be used for the first two weeks once a day, then two times a week after that. This gives the hormone a chance to build up in the system more effectively.  

Unlike other forms of hormone replacement therapy that are taken by mouth, Vagifem is inserted directly into the vagina using a smooth plastic applicator. The pill will come pre-loaded into the applicator, and all you'll need to do is press the plunger to release the medication once the applicator has been inserted into the vagina as directed.  There is no need to wash or reuse the applicator, simply throw it away. If your tablet falls out of the applicator before you use it, through that applicator away and use a new tablet. Do not attempt to re-insert the table in the applicator.  

What dosages are available? 

The dose of Vagifem you will be given by your doctor will depend on your response to treatment and the severity of your symptoms. You will need to use this medicine regularly and according to the instructions of your doctor to get the most benefit out of it.  

Follow the dosing schedule provided by your doctor carefully and do not attempt to increase the dose without speaking to your doctor if you feel as though you're not seeing results.Vagifem is available in doses of 10mcg and 25 mcg. Both of the doses are small white tablets that contain a specific amount of oestradiol. The tablets are 6mm in diameter and held in a disposable applicator. If you forget a dose of Vagifem, it's best to speak to your doctor, as the dosing regimen can vary according to your specific needs.  

What are the side effects of Vagifem? 

Medications for hormone replacement therapy that are applied directly inside of the vagina typically have fewer side effects than their oral counterparts. However, like any medication, there can be side effects when you take this tablet.  

The most common side effects are: 

  • Headaches 
  • Bloating 
  • Diarrhea 
  • Vomiting or nausea 
  • Breast tenderness 
  • Vaginal fungal or yeast infection 
  • Irregular vaginal bleeding 
  • Abdominal cramps or stomach pain 

Additional side effects might include weight increase, hot flushes, or feelings of high blood pressure that may leave you dizzy or unbalanced. If any of these symptoms worsen or persist, speak to a doctor or pharmacist as soon as you can.  

Serious side effects with Vagifem are rare. However, it's important to make sure that your doctor knows if you experience things like mood changes, memory loss, breast lumps, or increased vaginal discomfort. Severe stomach and abdominal pain, yellowing skin or eyes, or swelling hands or feet could be a sign of more serious problems.

Very rare side effects include: 

  • Fluid retention 
  • Worsened or heightened migraines 
  • Hair loss 

This medication may very rarely lead to problems caused by blood clots, such as strokes, heart attacks, and pulmonary embolism. If you notice any serious side effects, such as pain in your left arm or jaw, unusual sweating, or weakness on one side of the body, seek help immediately, Be aware of any signs of allergic reaction including trouble bleeding, sudden dizziness, swelling of the tongue, face or throat, or itching. You may also find that dangerous symptoms appear in the form of coughing up blood or sudden fainting. However, these symptoms are very rare.  

This is not a complete list of possible side effects for Vagifem. If you ever experience any unpleasant symptoms after taking this drug, make sure that you stop taking it immediately and seek help from a medical professional. There may be a slightly increased risk of clotting and womb cancer for people taking Vagifem. If you notice any unexpected bleeding from your vagina when using this substance, contact your GP immediately.  

When shouldn't you use Vagifem? 

It is important to discuss your medical history with your doctor before taking Vagifem or any hormone replacement therapy. If you have any allergies, even if you don't think the substances you are allergic to are included in this medication, speak to your doctor.  

You will also need to talk to your doctor or pharmacist about histories of vaginal bleeding, cancers of the uterus, ovaries, or breast, and blood clots or heart disease. Any family medical history of swelling disorders, blood clotting disorders, high blood pressure, and hormone conditions should also be mentioned.

Do not use Vagifem if: 

  • You usually suffer from unusual vaginal bleeding 
  • You've had a heart attack or stroke in the past 
  • You have or have had a blood clot 
  • You have or have had liver problems 
  • You have bleeding disorders 
  • You have thickened womb linings 
  • You are pregnant 

An assessment with a doctor should allow your GP to determine whether Vagifem is the right substance for your hormonal replacement therapy. Often, your doctor will recommend that you avoid using this substance if you smoke. Vagifem and other oestrogen substances combined with smoking can increase your risk of heart attack, blood clots, high blood pressure and stroke.  

In rare cases, this medication can cause dark and blotchy areas on your skin that are worsened by sunlight, which means that you may need to limit your time in the sun and avoid tanning booths. Additionally, if you wear contact lenses or are nearsighted, your medication may lead to vision problems. Speak to your doctor if these problems persist. The substances in Vagifem pass into breast milk, which may reduce the quality or level of breast milk produced. Contact your doctor before using Vagifem when breast feeding.  

Does Vagifem interact with any other medications? 

Research into the interactions that Vagifem has with other medications is currently very limited. However, it's important to speak to your doctor about any drugs that you're currently taking, as well as any over-the-counter medications or herbal substances.  

Vagifem may interact negatively with: 

  • Other medications that include oestrogen 
  • Inducers or inhibitors of CYP3A4 
  • Medication for epilepsy like phenobarbital and phenytoin 
  • Medications for tuberculosis like rifampicin 
  • Medications for HIV like nevirapine or ritonavir 
  • Any herbal remedies including St John's wort 

Where can you buy Vagifem? 

Vagifem is usually available in either 10 mcg or 25 mcg treatments online. You will be able to purchase this substance from a pharmacy, although you will need a prescription from your doctor to get the medication. You will also need to speak to your doctor so that you know how long you should be taking Vagifem.  

It may be possible to place repeat orders for a prescription of Vagifem online with certain companies. However, you will need to discuss this with your doctor.  

Can you get Vagifem without a prescription?  

While it is possible to purchase Vagifem online, you will need a prescription to get it. This is because it's important for your doctor to assess your condition carefully and determine whether Vagifem is the right hormone replacement therapy for you. Your doctor will also need to tell you how much Vagifem to take, and how long to take the medication for.  




John P. Cunha, DO, FACOEP, 2019, Vagifem Side Effects Drug Center, [Accessed 18th of June 2019] Available at:  

Kluwer Wolters. Standard Population Data. 2008. [Accessed 18th of June 2019]. Available at:

Novo Nordisk Limited, 2018, Novo Nordisk A/S, Vagifem patient leaflet, [Accessed 18th of June 2019], Available at:  

Novo Nordisk A/S (2017). Vagifem® 10 micrograms vaginal tablets. Electronic Medicines Compendium. [online] [accessed 15th March 2018]. Available at:  




Assessed by:

Dr Imran Malik, General practitioner
Registration number: GMC: 4741365

Dr Imran Malik studied undergraduate medicine at King's College University in Central London and clinical studies at the prestigious King's College Hospital. He graduated with a MBBS degree in 2000 and went on to gain postgraduate memberships with the Royal Society of Medicine and also General Practice in 2006.